Tuberculosis and Respiratory Diseases

  • 제84권2호
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  • Pages.115-124
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  • 2021
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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Factors Associated with Worsening Oxygenation in Patients with Non-severe COVID-19 Pneumonia

  • Hahm, Cho Rom (Department of Internal Medicine, Seoul Medical Center) ;
  • Lee, Young Kyung (Department of Radiology, Seoul Medical Center) ;
  • Oh, Dong Hyun (Department of Internal Medicine, Seoul Medical Center) ;
  • Ahn, Mi Young (Department of Internal Medicine, Seoul Medical Center) ;
  • Choi, Jae-Phil (Department of Internal Medicine, Seoul Medical Center) ;
  • Kang, Na Ree (Department of Internal Medicine, Seoul Medical Center) ;
  • Oh, Jungkyun (Department of Hospital Medicine, Seoul Medical Center) ;
  • Choi, Hanzo (Department of Emergency Medicine, Myong Ji St. Mary's Hospital) ;
  • Kim, Suhyun (Department of Internal Medicine, Seoul Medical Center)
  • 투고 : 2020.11.14
  • 심사 : 2021.01.01
  • 발행 : 2021.04.30
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초록

Background: This study aimed to determine the parameters for worsening oxygenation in non-severe coronavirus disease 2019 (COVID-19) pneumonia. Methods: This retrospective cohort study included cases of confirmed COVID-19 pneumonia in a public hospital in South Korea. The worsening oxygenation group was defined as that with SpO2 ≤94% or received oxygen or mechanical ventilation (MV) throughout the clinical course versus the non-worsening oxygenation group that did not experience any respiratory event. Parameters were compared, and the extent of viral pneumonia from an initial chest computed tomography (CT) was calculated using artificial intelligence (AI) and measured visually by a radiologist. Results: We included 136 patients, with 32 (23.5%) patients in the worsening oxygenation group; of whom, two needed MV and one died. Initial vital signs and duration of symptoms showed no difference between the two groups; however, univariate logistic regression analysis revealed that a variety of parameters on admission were associated with an increased risk of a desaturation event. A subset of patients was studied to eliminate potential bias, that ferritin ≥280 ㎍/L (p=0.029), lactate dehydrogenase ≥240 U/L (p=0.029), pneumonia volume (p=0.021), and extent (p=0.030) by AI, and visual severity scores (p=0.042) were the predictive parameters for worsening oxygenation in a sex-, age-, and comorbid illness-matched case-control study using propensity score (n=52). Conclusion: Our study suggests that initial CT evaluated by AI or visual severity scoring as well as serum markers of inflammation on admission are significantly associated with worsening oxygenation in this COVID-19 pneumonia cohort.

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과제정보

We thank the members of the Seoul Medical Centre Fight Against COVID-19 Team (SMC-FACT), all members of the department of emergency medicine, and other colleagues in the field. We would like to thank Editage (www.editage.co.kr) for English language editing.

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피인용 문헌

  1. The application of artificial intelligence and data integration in COVID-19 studies: a scoping review vol.28, pp.9, 2021, https://doi.org/10.1093/jamia/ocab098